The final chapter addresses the following question:Why do OECD countries adopt different organizational models to govern the healthcare sector? The strategic choices made in the healthcare field, and the reasons for which a particular model is selected, can be interpreted by referring to health politics. Adopting this perspective means starting from the assumption that healthcare policies emerge from an arena in which multiple actors, the bearers of different visions and interests, confront one another in an attempt to make their demands prevail. The issue of health politics is unpacked into three fundamental components: ideas, interests and institutions. The outcome of the confrontation between different ideas and conflicting interests is strongly influenced by the structure of the political institutions operating in each individual country. In countries where political power is more concentrated in the hands of the executive, over the decades it has tended to be easier to undertake radical reforms and adopt a universalist model.